Chlamydia eyed for hit list

By BRIDGET CARTER

Health officials are looking to reclassify one of the country's most common sexually transmitted infections, chlamydia, as part of a major review of part of the Health Act.

The move could mean people diagnosed with the disease would, by law, have to identify all of their recent sexual partners, who would then be contacted and told they could be a carrier.

The Ministry of Health's senior adviser on communicable diseases, Doug Lush, said the ministry knew reports of the disease were climbing and would release a discussion document about making chlamydia a notifiable disease in the next few months.

The ministry is looking at chlamydia, which is notifiable in other countries, at the same time as it reviews all notifiable diseases.

It is six years since the last major review of this aspect of the Health Act 1956.

nteChlamydia, dubbed "the quiet love bug", often has no symptoms and, if untreated, can cause infertility in women.

Rates here are five times higher than in Britain, Canada and Australia, says the Institute of Environmental Science and Research (ESR). Reported cases jumped from 2870 two years ago to 3238 last year.

In Northland, a special pilot programme involving GPs is about to investigate the costs of tracking down and treating potential carriers of the disease with antibiotics.

The move comes after a doubling of cases identified in the region's community laboratory since 2000.

Dr Lush said Northland's chlamydia figures were now twice that of its rate for the largest notifiable disease, campylobacter.

Making the disease notifiable would mean more detailed information could be collected so the ministry could launch appropriate education and control programmes, Dr Lush said.

But the Bay of Plenty's medical officer of health, Dr Phil Shoemack, said that while other sexually transmitted infections (STIs), including Aids, hepatitis A and hepatitis B, were already notifiable, he had concerns about putting chlamydia in the same category.

People might avoid getting treated because others would be informed, particularly if they were having an "on the side" relationship.

Sexual health clinics do trace chlamydia contacts now but, because it is not notifiable, they need the informed consent of the person they treat to do so.

If the disease was notifiable, a doctor treating a case would be required by law to inform the medical officer of health.

The medical officer's follow-up checks could include contacting a person and getting a list of all his or her recent sexual partners.

The partners could be advised that they may be carrying the disease.

Northland's medical officer of health, Dr Jonathan Jarman, who is running the special Northland programme, said that if the disease were notifiable, nurses could get in early and "hit it hard".

"This disease is running away on us."

Dr Jarman said one Kaikohe general practice was seeing four times as many cases as it saw five years ago.

The chairwoman of the GPs' council of the Medical Association, Dr Tricia Briscoe, said she supported making chlamydia notifiable, but only if the reclassification was accompanied by more funding, because it would mean more work for GPs.

"It is a small added task for general practitioners, but it is one of hundreds."

Dr Shoemack said reasons chlamydia was spreading could include people having more sexual partners or not practising safe sex.

It could also be because knowledge of chlamydia had grown, as tests had been available only in the past 20 years, he said.

Kitty Flannery, president of the New Zealand Venereological Society and manager of Hamilton Sexual Health Services, said untreated cases were mostly men, who usually had no symptoms.

Herald feature: Health